Organization
OUTSIDE IN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BILL ARONSON (INTERIM ASSOCIATE EXECUTIVE DIRECTR)
(503) 278-2514
Entity
Organization
Contact information
Practice address
1226 SW 12TH AVE, PORTLAND, OR 97205-2029
(503) 535-3898
Mailing address
1132 SW 13TH AVE, PORTLAND, OR 97205-1703
(503) 535-3800
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
11/03/2016
Last updated
08/06/2026
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